TPC 1350 - Change to Development Approval [As Published]

INTEGRATED PLANNING ACT 1997 Form 2, Version 4.1, 3 March 2008

4. Can the premises best be identified by coordinates (e.g. for development proposed in waters, or on a site within a large rural fol)?

{] No

LL] Yes - Complete Table D

5.  Whatis the total area that makes up the premises (i.e. the area covered by the application)?

 

 

 

 

 

 

 

 

 

Area of land above high water mark/outside watercourse Area in a water body or watercourse
850 om Dd hectares om CD hectares
, (Tick applicable unit) (Tick applicable unit)
Owner's consent and resource owner's agreement 4

 

6. _ Is the person making the request the owner of the land to which the approval attaches?

O Yes & No - Complete Table E - provide details for each owner on a separate row, or on an attachment to this form if applicable. Note: Advice
provided at the end of this form details when owner's consent is not required.

Table E

 

Owner’s-name/s and postal Details of the premises owned
address {street address or lot on plan description)

Date written consent

‘anatire*
Signature’ was obtained

 

1 | refer attached

 

 

 

 

 

 

 

* Owners signature can not be provided on the form if you intend to submit the application electronically. Owner's consent must be provided to the assessment manager on an
attachment containing eppropriate written documentation of the owner's consent. If the owner is a company the company must sign as owner. S127 of the Comorations Act
2001 (Cwealth) details how a company may execute a document.

7. If an application for the existing approval were being made now (i.e. af the time of making this request), would evidence be required to
support the application because it involved taking or interfering with a State-owned resource prescribed by schedule 10 of the integrated
Planning Regulation 1998 (IP Reg) or any other regulation

EX]No —_[_] Yes - Complete Table F and submit, with the application, written agreement to the request.

 

‘Nature of the request }
8. Whatis the nature of the request for change? (Tick the applicable box/es)

(1) An extension of the period before an approval lapses (under IPA, section 3.5.22)

Bx] To change the development approval other than a change of condition (under IPA, section 3.5.24)

(L] To change or cance! a condition of approval (under IPA, section 3.5.33) - Go fo Q11

o To change conditions of a rezoning approval given under the Local Government (Planning and Environment) Act 1990 (under IPA,
section 6.1.35) - Go fo Q12

9. Were one or more concurrence agencies involved in the approval?
X No oO Yes - Complete Table G. Submit, with the application, a copy of the notice required to be sent to each agency under IPA sections
3.5.22(1)(a) and 3.5.24(1)(b)
10. Does the request for change relate to an aspect of the approval that involved a building referral agency?

XK) No O Yes - Complete Table H. Submit, with the application, a copy of the notice required to be sent to each agency under IPA section
3.5.24(1)(b).

 

‘Details and reasons or justification for the request 4

11. What are the details of the requested change and the reasons or justification for the change? Use a different row for each change if more
than one.

 

Details of requested change (including extension of the period if relevant} Reasons or justification for the requested change i

 

=

alterations and modification to existing service station tefer attached letter